研究者詳細 - 大塚　基之

論文 - 大塚　基之

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高齢者におけるステント治療の現状と工夫高齢者の急性胆嚢炎におけるETGBDとEUS-GBDの比較検討

服部直, 宮本和也, 松本和幸, 加藤博也, 大塚基之

日本消化器病学会中国支部例会・日本消化器内視鏡学会中国支部例会プログラム・抄録集 120回・131回 62 - 62 2023年11月

膵神経内分泌腫瘍の治療中にうっ血性左側結腸炎を発症した1例

佐藤亮介, 堀口繁, 小幡泰介, 松三明宏, 宮本和也, 森本光作, 寺澤裕之, 藤井佑樹, 山崎辰洋, 内田大輔, 松本和幸, 堤康一郎, 加藤博也, 大塚基之

日本消化器病学会中国支部例会・日本消化器内視鏡学会中国支部例会プログラム・抄録集 120回・131回 84 - 84 2023年11月

ロボット支援下膵頭十二指腸切除術後の捻転を伴う輸入脚症候群に対して内視鏡的整復を行った1例

原田圭, 藤井佑樹, 小幡泰介, 佐藤亮介, 松三明宏, 宮本和也, 森本光作, 寺澤裕之, 山崎辰洋, 内田大輔, 松本和幸, 堀口繁, 堤康一郎, 加藤博也, 大塚基之

日本消化器病学会中国支部例会・日本消化器内視鏡学会中国支部例会プログラム・抄録集 120回・131回 112 - 112 2023年11月

短期間で急速に進行し、根治外科切除を行うも遠隔転移再発を来した十二指腸癌の一例

渋谷香苗, 河野吉泰, 神尾知宏, 平田翔一郎, 倉岡紗樹子, 稲生祥子, 里見拓也, 松枝克典, 濱田健太, 岩室雅也, 川野誠司, 河原祥朗, 高木弘誠, 楳田祐三, 田中健大, 大塚基之

日本消化器病学会中国支部例会・日本消化器内視鏡学会中国支部例会プログラム・抄録集 120回・131回 75 - 75 2023年11月

特発性肺線維症に対する肺移植後に重症膵炎を発症し、診断に苦慮した膵頭部癌の一例

矢杉賢吾, 堀口しげる, 小幡泰介, 佐藤亮介, 織田崇志, 菊池達也, 松三明宏, 宮本和也, 森本光作, 寺澤裕之, 藤井祐樹, 山崎辰洋, 内田大輔, 松本和幸, 堤康一郎, 加藤博也, 大塚基之

日本消化器病学会中国支部例会・日本消化器内視鏡学会中国支部例会プログラム・抄録集 120回・131回 85 - 85 2023年11月

消化器診療の先端診断と治療の新展開下咽頭表在癌スクリーニングにおける唾液中DCC遺伝子メチル化解析の有用性

平井亮佑, 衣笠秀明, 大塚基之

日本消化器病学会中国支部例会・日本消化器内視鏡学会中国支部例会プログラム・抄録集 120回・131回 45 - 45 2023年11月

Cysts or necrotic components in pancreatic ductal adenocarcinoma is associated with the risk of EUS-FNA/B complications including needle tract seeding. 国際誌

Hiroyuki Terasawa, Kazuyuki Matsumoto, Takehiro Tanaka, Takeshi Tomoda, Taiji Ogawa, Yuki Ishihara, Tatsuya Kikuchi, Taisuke Obata, Takashi Oda, Akihiro Matsumi, Kazuya Miyamoto, Kosaku Morimoto, Yuki Fujii, Tatsuhiro Yamazaki, Daisuke Uchida, Shigeru Horiguchi, Koichiro Tsutsumi, Hironari Kato, Motoyuki Otsuka

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 23 ( 8 ) 988 - 995 2023年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: EUS-FNA/B for pancreatic ductal adenocarcinoma (PDAC) is generally considered to be safe; however, while the incidence is low, there are occurrences of complications. Among these complications, there are serious ones like needle tract seeding (NTS), and it is not known than which types of tumors have the risks of EUS-FNA/B complications. This study aimed to evaluate the risk of EUS-FNA/B complications in patients with PDAC, focusing on morphological features. METHODS: Overall, 442 patients who underwent EUS-FNA/B for solid pancreatic masses between January 2018 and May 2022 in four institutions were retrospectively surveyed. Finally, 361 patients histopathologically diagnosed with PDAC were analyzed. Among these patients, 79 tumors with cysts or necrotic components were compared with 282 tumors without cysts or necrotic components. The incidence and risk of EUS-FNA/B complications including NTS were evaluated. RESULTS: There were 9 (2.4 %) of total EUS-FNA/B complications and 3 (0.8 %) of NTS. The incidence of total complication rate and NTS in tumors with cysts or necrotic components were significantly higher than in those without cysts or necrotic components (total complication 6.3 % vs. 1.4 %, p = 0.026, NTS 3.7 % vs. 0 %, p = 0.01). The transgastric route of puncture (OR: 93.3, 95 % CI: 3.81-2284.23) and the existence of cysts or necrotic components (OR: 7.3, 95 % CI: 1.47-36.19) were risk factors for EUS-FNA/B complications identified by the multivariate analysis. CONCLUSIONS: We should pay attention to the risks of EUS-FNA/B complications, including NTS, when the tumor has cysts or necrotic components.

DOI： 10.1016/j.pan.2023.10.018

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Optimal Bowel Preparation Method to Visualize the Distal Ileum via Small Bowel Capsule Endoscopy. 国際誌

Daisuke Kametaka, Mamoru Ito, Seiji Kawano, Shuhei Ishiyama, Akiko Fujiwara, Junichirou Nasu, Masao Yoshioka, Junji Shiode, Kazuhide Yamamoto, Masaya Iwamuro, Yoshiro Kawahara, Hiroyuki Okada, Motoyuki Otsuka

Diagnostics (Basel, Switzerland) 13 ( 20 ) 2023年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

Small bowel capsule endoscopy (SBCE) is a convenient and minimally invasive method widely used to evaluate the small intestine. However, especially in the distal ileum, visualization of the intestinal mucosa is frequently hampered by the remaining intestinal contents, making it difficult to detect critical lesions. Although several studies have reported on the efficacy of bowel preparation before SBCE, no standardized protocol has been established. Herein, we determined the optimal preparation method for better visualization of the distal ileum using SBCE. We retrospectively analyzed 259 consecutive patients who had undergone SBCE between July 2009 and December 2019, divided into three groups: Group A (no preparation except overnight fasting), Group B (ingestion of 1-2 L polyethylene glycol 4 h before colonoscopy after overnight fasting and performing SBCE immediately after colonoscopy), and Group C (ingestion of 0.9 L magnesium citrate [MC] before SBCE after overnight fasting). The visibility of the intestinal mucosa in the first 10 min and at the last 10 min during the period of observation of the distal ileum was examined using a scoring system and compared. The visibility of the images captured by SBCE was assessed based on the scoring of the degree of bile/chyme staining, residual fluid and debris, brightness, bubble reduction, and visualized mucosa. The status of intestinal collapse was also assessed. In the first 10 min of observation of the distal ileum, no significant differences were detected among the groups. In the last 10 min, significantly better images were acquired in Group C in terms of bile/chyme staining, brightness, bubble reduction, and visualized mucosa. Bowel preparation using a low-dose MC solution 2 h before SBCE provided significantly higher-quality images of the distal ileum. Further optimization, such as the timing of initiating the preparation, is necessary to determine the optimal regimen for bowel preparation prior to SBCE.

DOI： 10.3390/diagnostics13203269

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Idiopathic Gastric Antral Ulcers.

Masaya Iwamuro, Takehiro Tanaka, Seiji Kawano, Yoshiro Kawahara, Motoyuki Otsuka

Internal medicine (Tokyo, Japan) 63 ( 10 ) 1367 - 1371 2023年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

A Japanese woman presented with gastric antral ulcers accompanied by erosion and edema, demonstrating a chronic pattern of improvement and recurrence for more than six years. The patient had no relevant treatment history, and Helicobacter pylori infection was ruled out. Other potential etiologies contributing to gastric ulcers were eliminated on the basis of endoscopic biopsy and blood laboratory findings. Consequently, the patient was diagnosed with idiopathic gastric antral ulcer. This disease is often overlooked, and the chronological endoscopic images provided in this report can be used as a reference.

DOI： 10.2169/internalmedicine.2554-23

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Interventional EUSを用いた診療戦略-最適な低侵襲医療を目指して小病変かつ低悪性度の膵神経内分泌腫瘍に対するEUSガイド下低侵襲治療

松本和幸, 加藤博也, 大塚基之

Gastroenterological Endoscopy 65 ( Suppl.2 ) 1838 - 1838 2023年10月

AIを用いた経口胆道鏡検査の良悪性診断支援システムの開発

佐藤亮介, 松本和幸, 加藤博也, 河原祥朗, 大塚基之

Gastroenterological Endoscopy 65 ( Suppl.2 ) 2028 - 2028 2023年10月

Endoscopic Manifestations and Clinical Characteristics of Localized Gastric Light-Chain Amyloidosis.

Masaya Iwamuro, Shouichi Tanaka, Tatsuya Toyokawa, Mamoru Nishimura, Takao Tsuzuki, Koji Miyahara, Shin Negishi, Shogen Ohya, Takehiro Tanaka, Motoyuki Otsuka

Acta medica Okayama 77 ( 5 ) 545 - 552 2023年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

To determine the endoscopic and clinical features of localized gastric amyloid light-chain (AL) amyloidosis, we retrospectively examined the characteristics of nine patients (eight men and one woman) encountered by the hospitals in our network. Lesions were predominantly flat and depressed with surface vascular dilatation (n=5); others were characterized by subepithelial lesions (n=2), mucosal color change (n=1), and a mass-like morphology with swollen mucosal folds (n=1). Colonoscopy (n=7), video capsule enteroscopy (n=2), serum (n=5) and urine immunoelectrophoresis (n=4), and bone marrow examination (n=3) were performed to exclude involvement of organs other than the stomach. As treatment for gastric lesions of AL amyloidosis, one patient each underwent endoscopic submucosal dissection (n=1) and argon plasma coagulation (n=1), while the remaining seven patients underwent no specific treatment. During a mean follow-up of 4.2 years, one patient died 3.2 years after diagnosis, but the cause of death, which occurred in another hospital, was unknown. The remaining eight patients were alive at the last visit. In conclusion, although localized gastric AL amyloidosis can show various macroscopic features on esophagogastroduodenoscopy, flat, depressed lesions with vascular dilatation on the surface are predominant.

DOI： 10.18926/AMO/65978

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高齢者の食道表在癌・早期胃癌に対する内視鏡治療の適応と問題点後期高齢表在食道癌患者に対する内視鏡治療後長期成績の検討

松枝克典, 川野誠司, 大塚基之

日本消化器病学会雑誌 120 ( 臨増大会 ) A586 - A586 2023年10月

消化管領域における希少疾患に対する内視鏡診療消化管希少疾患 gastric adenocarcinoma and proximal polyposis of the stomach(GAPPS)の2家系の報告

平井亮佑, 川野誠司, 大塚基之

Gastroenterological Endoscopy 65 ( Suppl.2 ) 1906 - 1906 2023年10月

The efficacy of non-anesthesiologist-administered propofol sedation with a target-controlled infusion system during double-balloon endoscopic retrograde cholangiopancreatography. 国際誌

Kazuya Miyamoto, Kazuyuki Matsumoto, Taisuke Obata, Ryosuke Sato, Akihiro Matsumi, Kosaku Morimoto, Taiji Ogawa, Hiroyuki Terasawa, Yuki Fujii, Tatsuhiro Yamazaki, Daisuke Uchida, Shigeru Horiguchi, Koichiro Tsutsumi, Hironari Kato, Motoyuki Otsuka

BMC gastroenterology 23 ( 1 ) 296 - 296 2023年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The sedation method used during double-balloon endoscopic retrograde cholangiopancreatography (DB-ERCP) differs among countries and/or facilities, and there is no established method. This study aimed to evaluate the efficacy of non-anesthesiologist-administered propofol (NAAP) sedation using a target-controlled infusion (TCI) system during DB-ERCP. METHODS: This retrospective study was conducted between May 2017 and December 2020 at an academic center. One hundred and fifty-six consecutive patients who underwent DB-ERCP were sedated by gastroenterologists using diazepam (n = 77) or propofol with a TCI system (n = 79), depending on the period. The primary endpoint was a comparison of poor sedation rates between the two groups. Poor sedation was defined as a condition requiring the use of other sedative agents or discontinuation of the procedure. Secondary endpoints were sedation-related adverse events and risk factors for poor sedation. RESULTS: Poor sedation occurred significantly more often in the diazepam sedation group (diazepam sedation, n = 12 [16%] vs. propofol sedation, n = 1 [1%]; P = 0.001). Vigorous body movements (3 or 4) (diazepam sedation, n = 40 [52%] vs. propofol sedation, n = 28 [35%]; P = 0.038) and hypoxemia (< 85%) (diazepam sedation, n = 7 [9%] vs. propofol sedation, n = 1 [1%]; P = 0.027) occurred significantly more often in the diazepam sedation group. In the multivariate analysis, age < 70 years old (OR, 10.26; 95% CI, 1.57-66.98; P = 0.015), BMI ≥ 25 kg/m2 (OR, 11.96; 95% CI, 1.67-85.69; P = 0.014), and propofol sedation (OR, 0.06; 95% CI, 0.01-0.58; P = 0.015) were associated factors for poor sedation. CONCLUSIONS: NAAP sedation with the TCI system during DB-ERCP was safer and more effective than diazepam sedation.

DOI： 10.1186/s12876-023-02936-8

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先天性胆道拡張症術後の肝内胆管狭窄に対し内視鏡的胆道拡張術が有効であった一例

宮本和也, 加藤博也, 小幡泰介, 佐藤亮介, 松三明宏, 森本光作, 藤井佑樹, 山崎辰洋, 内田大輔, 松本和幸, 堀口繁, 堤康一郎, 大塚基之

日本膵・胆管合流異常研究会プロシーディングス 46 76 - 76 2023年9月

IBD診療におけるtreat to targetを考える Treat to targetを意識したクローン病におけるsurrogate markerの組み合わせ

井口俊博, 平岡佐規子, 青山祐樹, 竹井健介, 井川翔子, 高原政宏, 大塚基之

日本大腸肛門病学会雑誌 76 ( 9 ) A51 - A51 2023年9月

胆膵癌ゲノムパネル検査における検査法についての検討(Investigation of test methods for pancreatobiliary cancer genomic panel test)

堀口繁, 加藤博也, 松本和幸, 大塚基之

日本癌学会総会記事 82回 828 - 828 2023年9月

Biological Roles of Hepatitis B Viral X Protein in the Viral Replication and Hepatocarcinogenesis.

Motoyuki Otsuka

Acta medica Okayama 77 ( 4 ) 341 - 345 2023年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

Hepatitis B virus is a pathogenic virus that infects 300 million people worldwide and causes chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Hepatitis B virus encodes four proteins. Among them, the HBx protein plays a central role in the HBV pathogenesis. Because the HBx protein is considered to play a central role in the induction of viral replication and hepatocarcinogenesis, the regulation of its function could be a key factor in the development of new interventions against hepatitis B. In this review, HBx protein-related viral replication and hepatocarcinogenesis mechanisms are described, with a focus on the recently reported viral replication mechanisms related to degradation of the Smc5/6 protein complex. We also discuss our recent discovery of a compound that inhibits HBx protein-induced degradation of the Smc5/6 protein complex, and that exerts inhibitory effects on both viral replication and hepatocarcinogenesis. Finally, prospects for future research on the HBx protein are described.

DOI： 10.18926/AMO/65739

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岩室雅也, 田中健大, 大塚基之

消化器内視鏡 35 ( 8 ) 1072 - 1074 2023年8月

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